Rumbeiha Wilson K, Kim Dong-Suk
Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
Neurol Int. 2025 May 6;17(5):71. doi: 10.3390/neurolint17050071.
Hydrogen sulfide (HS) is a highly potent toxic gas, and the brain is a primary target organ following acute intoxications. Accidents and misuse of this gas for nefarious purposes, i.e., bioterrorism, are causes for concern regarding acute poisoning. The immediate effects of acute HS poisoning are well known. Numerous publications have reported neurological sequelae, including insomnia, persistent headaches, ataxia, cognition deficits, hearing impairment, dysarthria, and neuropsychiatric behaviors, among survivors of acute HS poisoning. However, this subject remains controversial. The goal of this study was to review the literature on acute HS-poisoning-induced neurological sequelae and on animal models to determine prevalence and knowledge gaps. We also reviewed the literature on cyanide-induced neurological sequelae. The results of large population studies indicate that the majority of victims of acute HS poisoning survive. There is a lack of patient follow-up and standardized neuropsychological, neurological, and neuroimaging for accurate assessments. We observed flaws in animal models that failed to recapitulate the severe neurotoxicity induced via the inhalation route. We observed a paucity of literature on cyanide-induced neurological sequelae. In contrast to cyanide-induced sequelae, predominantly characterized by Parkinsonian-like motor behavioral deficits, HS patients exhibit mostly cognition deficits, speech impairment, and neuropsychological effects. This first comprehensive review of neurological sequelae induced by HS and cyanide poisonings identified knowledge gaps in the prevalence of these sequelae and cellular and molecular mechanisms underlying them. It is unclear whether these sequelae are reversible. There are no FDA-approved drugs for the prevention or treatment of these sequelae. Notably, patients who received life-saving therapy still developed delayed neurological sequelae.
硫化氢（HS）是一种剧毒气体，急性中毒后大脑是主要的靶器官。该气体因意外事故或被用于邪恶目的（即生物恐怖主义）而导致的急性中毒令人担忧。急性硫化氢中毒的直接影响是众所周知的。许多出版物都报道了急性硫化氢中毒幸存者出现的神经后遗症，包括失眠、持续性头痛、共济失调、认知缺陷、听力障碍、构音障碍和神经精神行为。然而，这个问题仍然存在争议。本研究的目的是回顾关于急性硫化氢中毒引起的神经后遗症及动物模型的文献，以确定其发生率和知识空白。我们还回顾了关于氰化物引起的神经后遗症的文献。大规模人群研究结果表明，急性硫化氢中毒的大多数受害者存活下来。目前缺乏对患者的随访以及标准化的神经心理学、神经学和神经影像学检查来进行准确评估。我们发现动物模型存在缺陷，无法重现吸入途径导致的严重神经毒性。我们观察到关于氰化物引起的神经后遗症的文献很少。与主要表现为帕金森样运动行为缺陷的氰化物引起的后遗症不同，硫化氢中毒患者主要表现为认知缺陷、言语障碍和神经心理学影响。这首次对硫化氢和氰化物中毒引起的神经后遗症进行的全面综述，确定了这些后遗症的发生率以及其潜在的细胞和分子机制方面存在的知识空白。目前尚不清楚这些后遗症是否可逆。美国食品药品监督管理局（FDA）尚未批准用于预防或治疗这些后遗症的药物。值得注意的是，接受过挽救生命治疗的患者仍出现了延迟性神经后遗症。
